Charles A. Gusho, BS; Tannor A. Court, BS
Introduction: Pulmonary blastomycosis is a rare fungal disease with increased prevalence in states such as Wisconsin. Clinical manifestations of blastomycosis may vary from asymptomatic infection to multiorgan, disseminated disease.
Case Presentation: We present 2 pediatric patients with blastomycosis who were initially worked up secondary to cough and fever of suspected bacterial origin, though whose subsequent hospital course was notable for deterioration until antifungal treatment was initiated.
Discussion: In each case, the disease burden was monitored concurrently with serum procalcitonin and C-reactive protein levels, the former of which remained relatively normal throughout the hospital course signifying lack of bacterial involvement.
Conclusion: We emphasize the importance of obtaining an early C-reactive protein and procalcitonin, which may distinguish a bacterial from fungal pulmonary infection such as blastomycosis. This, in turn, may shorten hospital stay and reduce hospital inpatient cost, morbidity, and mortality by means of prompt antifungal intervention.